Menstrual Disorders

Managing menstrual disorders with expert care

Menstrual cycles are a regular part of life for most women, from their teenage years to menopause. More than 90% experience some symptoms of premenstrual syndrome (PMS). While mild symptoms can be common, severe pain, irregular periods, heavy bleeding, or significant emotional symptoms may be signs of an underlying menstrual disorder or other health conditions.  

The Women’s Health team at Reid Health, provides comprehensive evaluation and treatment to help you manage symptoms and get back to daily life.  

Types of menstrual disorders we treat

Premenstrual syndrome (PMS)

Premenstrual syndrome, or PMS refers to physical and emotional symptoms that occur one to two weeks before your period. These symptoms are related to hormone changes associated with the menstrual cycle.  

Many women experience mild symptoms, while for others, severe symptoms make it difficult to do everyday tasks. Severe  PMS symptoms include:

• Bloating
• Breast tenderness or swelling
• Clumsiness or feeling “off balance”
• Cramping
• Cravings or changes in appetite
• Diarrhea or constipation
• Difficulty concentrating
• Fatigue or feeling extra tired
• Headache  
• Irritability or mood changes
• Joint or muscle pain
• Trouble sleeping

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. It also occurs one to two weeks before your menstrual cycle. About 5% of people of reproductive age are affected by PMDD.

PMDD includes the physical symptoms of PMS along with significant emotional or behavioral changes, including:

• Anger or significant irritability
• Binge eating
• Feelings of hopelessness depression
• Lack of interest in activities or relationships
• Panic attacks
• Severe mood swings
• Thoughts of hurting yourself or someone else

The emotional symptoms of PMDD can be very serious. Get help right away if you’re thinking of hurting yourself or others. Call or text 988 (Suicide & Crisis Lifeline), call 911, or go to your nearest Emergency Department. 

More than half of women experience some degree of menstrual pain, which is caused by uterine contractions that help blood and tissue leave the body. For many, menstrual pain often decreases as you get older.

You can have menstrual pain caused by another health condition. This is known as secondary dysmenorrhea, and it often gets worse with age. Common causes include:

• Endometriosis
• Uterine fibroids
• Ovarian Cysts 

Irregular periods

Irregular periods are common during the teen years and in the perimenopausal transition (the months and years leading up to menopause). For most people of reproductive age, irregular periods might be a sign of underlying health conditions including:

• Thyroid disorders
• Uncontrolled diabetes
• Pelvic inflammatory disease (infection of the reproductive organs)
• Polycystic ovary syndrome (PCOS)
• Primary ovarian insufficiency (when the ovaries don’t function normally)

Heavy menstrual bleeding

About one in five women in America will experience heavy periods every year. Heavy bleeding and the coinciding pain might interfere with daily activities, work, or school.

Possible causes of heavy bleeding include:

• Bleeding disorders
• Ovulation problems
• Uterine lining abnormalities
• Thyroid issues
• Uterine fibroids

Unusual bleeding

Unusual (or abnormal) bleeding is any bleeding that differs from your typical period, happens between periods, or happens after menopause. Unusual bleeding can happen for many reasons. Some are minor and can be easily treated, others more serious.  

Unusual bleeding might be a sign of:

• Cervical, uterine, or ovarian cancer
• Endometriosis
• Hormonal changes
• Ovarian cysts

When to talk with your provider

If you're dealing with PMS, heavy bleeding, or other menstrual changes, discussing these with your provider is essential. Contact your provider if you:  

• Feel lightheaded, dizzy, weak, or have shortness of breathing during or after your period
• Have periods lasting longer than eight days
• Experience cycles shorter than 24 days or longer than 38 days
• Pass blood clots larger than a quarter
• Notice sudden changes after having regular cycles

Keeping track of your cycle can help identify changes and prepare for your conversation with your provider, whether you use a calendar or an app to note symptoms. 

Treating and managing PMS and other menstrual disorders

Treatments options for PMS and other menstrual disorders depend on several factors including the underlying cause, severity of symptoms, and your personal medical history.  

Common treatments options may include:

• Antidepressant or anti-anxiety medication
• Hormonal therapies such as birth control pills, the contraceptive injection, hormonal intrauterine device (IUD), or the vaginal ring
• Medication or treatments to address underlying conditions
• Mindfulness techniques
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin
• Procedures that aim to lighten menstrual bleeding

Staying healthy by eating a balanced diet, exercising regularly, drinking enough water, and getting plenty of sleep might also help manage PMS symptoms.